Why is A1C important

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Why the HbA1c value is so important!

Dealing with the disease on a day-to-day basis is one challenge that diabetics have to deal with, the long-term prevention of additional secondary diseases is the other.

The big problem: It usually takes many years before diabetes is diagnosed, during which the blood sugar is usually too high and the first fine vessels and nerves are damaged as a result. This damage progresses insidiously and is hardly noticed by diabetics due to the reduced pain sensation. It is not uncommon for these "small", poorly noticeable changes to end in the dreaded diabetes-related complications. But it doesn't have to be!

Studies show that good blood sugar control can reduce the risk of diabetes-related complications.

HbA1c - the important hieroglyph in diabetes therapy

In addition to the fasting blood sugar, an important parameter for assessing a good blood sugar control is the HbA1c value. Many diabetics have heard of it before, but very few know what this value means and why it is so important.

The HbA1c value indicates the proportion of the "sugared" red blood pigment (hemoglobin) in the total hemoglobin. This stable "sugar hemoglobin", known as "glycosylated hemoglobin" or "HbA1c" in technical terms, occurs in every person, not just diabetics, and is dependent on the average blood sugar concentration. Put simply: the higher the blood sugar level over a certain period of time, the higher the HbA1c value.

With the HbA1c value, the doctor can therefore determine the average blood sugar level for the last 8 to 10 weeks, regardless of whether the values ​​have risen or fallen sharply in the meantime. This is why the HbA1c value is often also called "Long-term blood sugar memory" designated.

As early as 1999, the World Health Organization (WHO) recommended the HbA1c value as an important parameter for assessing the quality of the diabetic control in addition to blood sugar measurement and the gucose tolerance test. The HbA1c value is therefore often referred to as the "gold standard" in diabetes therapy.

HbA1c - healthier under 7

The HbA1c value can be used to tell whether the blood sugar is well adjusted. Because the better the blood sugar is adjusted, the lower the HbA1c value!

In healthy people, the HbA1c value is between 4.5 and 6.5 percent, in patients with well-controlled diabetes it is between 6.5 and 7.0 percent, and in poorly controlled diabetics it is over 7.5 percent.

In general, the lower the HbA1c value, the lower the risk of secondary diseases.

The results of one of the largest studies on the treatment of type 2 diabetes showed that a 1% reduction in the HbA1c value was linked to:

  • 21%igen reduction of the risk for diabetes-related complications
  • 25%igen reduction in diabetes-related deaths
  • 17%igen reduction in All mortality
  • 18%igen reduction of risk, one Heart attack to suffer
  • 15%own risk reduction for Strokes
  • 35%igen to reduce the risk of secondary diseases eye and kidney

The current guidelines of the specialist societies recommend an HbA1c value below 6.5 percent for the prevention of diabetes-related complications and an adjustment of therapy from an HbA1c value above 7.

The fact is, however, that almost every second type 2 diabetic with an HbA1c level above 7.5 percent is poorly controlled.

Consequences of poorly controlled diabetes

Permanently high blood sugar values, which are reflected in a high HbA1c value, damage the large and small blood vessels (macro and microangiopathy) and the nerves (neuropathy). Due to narrowed or even closed vessels (arteriosclerosis), the tissue is no longer adequately supplied with nutrients.

The most common secondary diseases include:

  • diabetic foot
  • Nerve damage
  • Damage to the cardiovascular system
  • Eye damage
  • Damage to the kidneys

The results are shocking: According to the CODE-2 study, the following new diabetic diseases occur every year in Germany:

  • Foot ulcers 58,000
  • Strokes 44,000
  • Amputations 28,000
  • Heart attacks 27,000
  • Dialysis cases from kidney failure: 6,000
  • Blindness 6,000

last edited: 03/31/2003, last updated: 02/11/2014